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5 Results for Contextual Factors

5.4 Coordination

5.4.1 Coordination

The search strategy on this contextual factor captured 662 peer reviewed articles, the vast majority of which (637) either did not discuss humanitarian crises or did not consider the impact of coordination on a public health intervention during crisis.

There is little available evidence assessing the impact of coordination on the effectiveness of health interventions during humanitarian crises (25 papers).

There is increasing interest in the characterisation of the impact of coordination on healthcare interventions during humanitarian crises, with 22/25 (88%) of all studies conducted since 1980 being published in the last decade.

The majority of available evidence is of low to moderate quality: 13/25 (52%) of papers were from category C evidence, 8/25 (32%) were from category B, and only 4/25 (16%) were from category A.

All studies were observational. All studies were purely descriptive, a study design very low down in the hierarchy of evidence. Only one of these was comparative, comparing two humanitarian information coordination bodies.

Of the location-identified research on coordination during humanitarian crises, Haiti and Pakistan were the most commonly studied countries (4/25, 16% papers each). A further 10/25 (40%) papers considered multiple (more than two) different countries across regions.

Evidence for the different types of humanitarian crises focused primarily on natural disasters: 10/25 (40%) considered these, in particular earthquakes, floods and tsunamis. 8/25 (32%) considered armed conflict only, and 7/25 (28%) considered both armed conflict and natural disasters.

Most papers (21/25, 84%) focused on the general population; 2/25 (8%) considered entrapped populations, one paper considered IDPs only, and one paper considered both IDPs and refugees.

Most papers (21/25, 84%) considered both urban and rural settings, 4/25 (16%) considered only the rural setting, and no studies considered only the urban environment.

Regarding the types of public health interventions, 14/25 (56%) articles considered the coordination of international medical assistance agencies with existing health services. 9/25 (36%) further articles considered the coordination of only international medical assistance agencies. Just 2/25 (8%) studies considered the coordination of only domestic humanitarian capabilities (both were conducted in China).

Of the available evidence on health coordination during humanitarian crises, 9/25 (36%) studies considered the UNOCHA and Cluster Approach systems, and 3/25 (12%) studies considered civil-military coordination. The majority of remaining papers (10/25, 40%) explored various domains of coordination which could be improved to increase the overall effectiveness of coordination during humanitarian crises, including: institutional and social networks (4 papers), trust between agencies (2), disaster preparedness and response (1), information management (1), logistics (1), and operational security (1).

Basic, general and primary healthcare services together formed the public healthcare area most studied regarding coordination during humanitarian crises (21/25, 84%). Of the remaining studies, there was one article written on each of the following health areas: hospital inpatient and surgical care; patient medical transfers; distribution of medical materials; and sexual and reproductive health.

Concerning stage of crisis, the majority (16/25, 64%) of studies focused on the acute phase, only 1/25 (4%) on early recovery, and 8/25 (32%) on chronic situations.

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